Research goals: to determine most frequent causes of massive bleeding in patients treated in Intensive Care Unit (ICU), present local strategy of transfusion treatment, to determine whether the conventional or new guidelines are being followed, and whether resuscitation strategy influences treatment outcome.
Study type: retrospective study
Patients and methods: examinees are ICU patients treated for hemorrhagic shock in period from 1st January 2012 to 31st December 2015. Data was acquired from patient case histories and hospital records, including sources of hemorrhage, volume of intravenous fluids and blood, necessity for surgical hemostasis and treatment outcome.
Results: study included 52 patients, median age 61 (44.75-73.25), with slightly larger male population (59.6 %). They were treated in ICU during 3 (2-6) days. In 67.3 % cases, bleeding was caused by trauma.
During resuscitation, median of 8.8 L of fluid was infused, with blood products share being 27 %. Median ratio of Plasma (FFP): Erythrocyte (pRBC) was 1:2.38 , and total mortality rate was 42.3 %. In 17 patients FFP: pRBC ratio of 1:2.38 was achieved, with mortality rate being 52.94 %, while in 33 patients the ratio was smaller or same, with mortality rate being 39.9 %.
Conclusion: Most common cause of massive hemorrhage is trauma. In initial resuscitation crystalloid solutions were administered (>2/3 of infused fluids). Implementing new guidelines did not influence local transfusion therapy strategy.
Owing to small number of examinees, it is not possible to conclude how much resuscitation strategy influences treatment outcome in bleeding patients.